Diagnosis and management of intraductal papillary mucinous neoplasia

Intraductal papillary mucinous neoplasia (IPMN) encompasses a spectrum of neoplastic change in the epithelial lining of the pancreatic duct. As such, it is difficult to predict the presence of malignancy, and pancreatic resection is established as the only effective treatment for IPMN. There is controversy about the natural history, evaluation, surgical management and surveillance of IPMN; as IPMN is being increasingly recognized, this controversy is being brought to the forefront of clinical practice. This review presents pooled surgical data, future directions and a proposed algorithm for the management of patients with IPMN.